Vital statistics

Draper et al, provide a fascinating insight into the pitfalls of reading reports of neonatal outcome data that compare outcomes between different health systems. They studied this across 10 European regions, ascertaining the outcomes of all pregnancies that ended in delivery between 22+0 and 31+6 week’s gestation. Differences in antenatal screening policies had a large effect through the number of terminations of pregnancy for congenital anomalies. Excluding these pregnancies and considering only those alive at the onset of labour, differences remained striking. In one region 26.5% of those less than 24 week’s gestation who were alive at the onset of labour were documented as being born alive in comparison with 89.8% at the other extreme. The percentages of pregnancies resulting in an infant being admitted for neonatal intensive care at this gestation varied from 0 to 80%. Survival to discharge across all 10 regions for infants alive at the onset of labour between 24 and 27 weeks varied from 41.5 to 80%. How ever much care is taken to ensure that statistics compare like with like, it appears that policy, ethical and cultural differences begin to …